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Elektronenmikroskopische Untersuchung eines extramammären Morbus Paget

Electron Microscopic Investigation of an extramammary paget disease

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Summary

In one case of extramammary Paget's disease electronmicroscopic examination of the epidermis disclosed the following:

  1. 1.

    Cells with distinct structural deviation from the norm may be seen in the lower epidermis. These contain tonofilaments which are diminished, arranged like stubble or loosened only in a rudimentary way, generelly enclosed in an edematose cytoplasma. Endoplasmatic reticulum and Golgi-apparatus are extensive, swollen mitochondria slighthly increased. There are few near normal, at times rudimentarily structured desmosomes.

  2. 2.

    Alongside such cells there are others, similar in principle, but with lesser deviations of the tonofilaments.

  3. 3.

    Between these cells there are cell mitosis which similarly changed tonofilaments and structurally normal desmosomes.

  4. 4.

    The epidermal cells lying above these, in the upper Malpighilayer, show more or less the same tonofilament structure, but the number of tonofilaments is generally substantially increased.

  5. 5.

    The Processes of differentiation in the granular and horn layers seem to differ from the norm. Especially there are distinct indentations of the cell nucleus and stronger lysosomal reaction.

  6. 6.

    On the basis of these findings the altered cells in the lower epidermis, which may differentiate upwards, seem to correspond to artificially ballooning “Paget cells”.

Zusammenfassung

Bei einem extramammären Morbus Paget wurden die epidermalen Veränderungen elektronenmikroskopisch untersucht. Es läßt sich folgendes finden:

  1. 1.

    In der unteren Epidermis lassen sich strukturell deutlich von der Norm abweichende Zellen erkennen. Diese enthalten verminderte, stoppelförmig geordnete oder nur rudimentär aufgelockerte Tonofilamente meistens in einem ödematösen Cytoplasma. Endoplasmatisches Reticulum und Golgi-Apparate sind weitgehend, angeschwollene Mitochondrien leicht vermehrt. Es finden sich wenige fast normale, gelegentlich rudimentär strukturierte Desmosomen.

  2. 2.

    Neben solchen Zellen lassen sich prinzipiell ähnliche jedoch mit geringeren Veränderungen der Tonofilamente erkennen.

  3. 3.

    Zwischen diesen Zellen finden sich Zellteilungsfiguren mit in gleicher Weise veränderten Tonofilamenten und strukturell normalen Desmosomen.

  4. 4.

    Die darüberliegenden Epidermiszellen in der oberen Malpighischicht weisen mehr oder weniger gleichartige Strukturen der Tonofilamente auf, jedoch vermehrt sich zumeist die Anzahl der Tonofilamente deutlich.

  5. 5.

    Die Differenzierungsprozesse in der Granular- und Hornschicht scheinen vom Normalen modifiziert zu verlaufen. Insbesondere zeigen sich deutliche Einkerbungen der Zellkerne und stärkere lysosomale Reaktion.

  6. 6.

    Nach diesen Befunden scheinen die veränderten Zellen in der unteren Epidermis, die sich nach oben differenzieren können, den lichtmikroskopisch darstellbaren, artifiziell ballonierenden “Pagetzellen” zu entsprechen.

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  1. Universitäts-Hautklinik Bonn, Bonn, Deutschland

    Y. Ishibashi, G. Jäger & G. Klingmüller

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  1. Y. Ishibashi
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Ishibashi, Y., Jäger, G. & Klingmüller, G. Elektronenmikroskopische Untersuchung eines extramammären Morbus Paget. Arch. klin. exp. Derm. 234, 293–314 (1969). https://doi.org/10.1007/BF00499538

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